Inflammatory and tumor-like lesions of the pancreas

Luchini, Claudio; Fassan, Matteo; Doglioni, Claudio; Capelli, Paola; Ingravallo, Giuseppe; Renzulli, Giuseppina; Pecori, Sara; Paolino, Gaetano; Florena, Ada Maria; Scarpa, Aldo; Zamboni, Giuseppe

doi:10.32074/1591-951x-168

Cited by 9 publications

(4 citation statements)

References 53 publications

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“…During the final stage there is the destruction of islets of Langerhans with replacement of endocrine cells with fibrotic tissue, 14 In severe cases there is atrophy of pancreatic tissue while fatty and fibrotic tissue completely replaces the healthy pancreatic tissue. The islets are completely lost in this final stage, 15 Histopathologically, the presence of inflammation, fatty changes, increased number of islets of Langerhans and hypertrophy of islets are directed towards the initial stages of development of IDDM. 16 However, the time duration of the current study was not long enough to show the final stages of the development of IDDM.…”

Section: Discussionmentioning

confidence: 99%

Statin Induced Changes in Rat Pancreatic Tissue: A Histological and Biochemical Perspective

Qamar,

Khan,

Khan

et al. 2024

JRMC

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Objective: This study aimed to elucidate the effects of simvastatin on pancreatic histomorphology and biochemical profile in a rat model. Method: Forty male Sprague-Dawley rats weighing 250 g were divided into two equal groups: a control group (A) and an experimental group (B) treated with simvastatin 60 mg/kg/day for 12 weeks. At the end of the experiment, the rats were euthanized, and their pancreas was collected for analysis and examined using gold-standard histological parameters including inflammation and fatty infiltration. Biochemical parameters i.e. serum amylase and alkaline phosphatase were also analysed. Statistical Package for the Social Sciences (SPSS) software version 23 was employed for data analysis. Mean ± SD was employed to express quantitative variables. Qualitative variables were expressed as frequencies and percentages. Chi-square tests compared qualitative variables while independent sample t-tests compared quantitative variables between groups, with P < 0.05 defining statistical significance. Results: The administration of Simvastatin resulted in a substantial induction of pancreatic inflammation and fatty infiltration, accompanied by notable alterations in the biochemical profile. Specifically, there was a significant reduction in serum amylase levels and a concomitant increase in serum alkaline phosphatase (ALP) levels, as compared to the control group. Conclusion: This study demonstrates that simvastatin profoundly alters pancreatic histomorphology in rats, resulting in marked inflammation, necrosis, fatty infiltration, and interstitial fibrosis. These novel findings provide unique insights into simvastatin's effects on pancreatic morphology using a robust animal model. Keywords: Simvastatin; Sprague-Dawley rats; pancreatic histomorphology, Amylase, Alkaline phosphatase.

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Section: Discussionmentioning

confidence: 99%

Statin Induced Changes in Rat Pancreatic Tissue: A Histological and Biochemical Perspective

Qamar,

Khan,

Khan

et al. 2024

JRMC

View full text Add to dashboard Cite

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“…There are a number of explanations that could be responsible for this deviation. In fact, the preoperative diagnosis of GP still represents a challenge for clinicians, as this pathology belongs to the heterogeneous group of “inflammatory/tumour-like lesions” of the pancreas: as suggested by their name, these disorders can mimic a cancer or another malignant neoplasm of the pancreatic gland, leading to a certain rate of misdiagnosis and, consequently, to under- or overtreatment [ 29 ]. The preoperative radiological diagnosis of GP could prove extremely arduous - even in specialized centers - for untrained radiologists, and its subtle, often unspecific histological features make preoperative sampling not useful or confusing at times [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Surgery for chronic pancreatitis: the comparison of two high-volume centers reveals lack of a uniform operative management

Surci

Bassi²,

Salvia³

et al. 2021

Langenbecks Arch Surg

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Purpose Many aspects of surgical therapy for chronic pancreatitis (CP), including the correct indication and timing, as well as the most appropriate operative techniques, are still a matter of debate in the surgical community and vary widely across different centers. The aim of the present study was to uncover and analyze these differences by comparing the experiences of two specialized surgical units in Italy and Austria. Methods All patients operated for CP between 2000 and 2018 at the two centers involved were included in this retrospective analysis. Data regarding the clinical history and the pre- and perioperative surgical course were analyzed and compared between the two institutions. Results Our analysis showed a progressive decrease in the annual rate of pancreatic surgical procedures performed for CP in Verona (no. = 91) over the last two decades (from 3% to less than 1%); by contrast, this percentage increased from 3 to 9% in Vienna (no. = 77) during the same time frame. Considerable differences were also detected with regard to the timing of surgery from the first diagnosis of CP — 4 years (IQR 5.5) in the Austrian series vs two (IQR 4.0) in the Italian series -, and of indications for surgery, with a 12% higher prevalence of groove pancreatitis among patients in the Verona cohort. Conclusion The comparison of the surgical attitude towards CP between two surgical centers proved that a consistent approach to this pathology still is lacking. The identification of common guidelines and labels of surgical eligibility is advisable in order to avoid interinstitutional treatment disparities.

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“…In particular, chronic and autoimmune pancreatitis (CP, AIP) can occasionally appear at cross-sectional imaging as mass-forming inflammatory lesions, representing a considerable diagnostic challenge even for experienced radiologists [ 4 ]. Likewise, other rare tumour-like conditions—e.g., lymphoepithelial cysts, pancreatic hamartoma and intrapancreatic accessory spleen (IPAS)—are in some cases difficult to differentiate from PDAC and/or pNET only on the basis of imaging, markers and clinical presentation [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The Rate of Avoidable Pancreatic Resections at a High-Volume Center: An Internal Quality Control and Critical Review

Surci

Rösch

Kirchweger

et al. 2023

JCM

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Background: The incidence of benign diseases among pancreatic resections for suspected malignancy still represents a relevant issue in the surgical practice. This study aims to identify the preoperative pitfalls that led to unnecessary surgeries at a single Austrian center over a twenty-year period. Methods: Patients undergoing surgery for suspected pancreatic/periampullary malignancy between 2000 and 2019 at the Linz Elisabethinen Hospital were included. The rate of “mismatches” between clinical suspicion and histology was considered as primary outcome. All cases that, despite that, fulfilled the indication criteria for surgery were defined as minor mismatches (MIN-M). Conversely, the true avoidable surgeries were identified as major mismatches (MAJ-M). Results: Among the 320 included patients, 13 (4%) presented with benign lesions at definitive pathology. The rate of MAJ-M was 2.8% (n = 9), and the most frequent causes of misdiagnoses were autoimmune pancreatitis (n = 4) and intrapancreatic accessory spleen (n = 2). In all MAJ-M cases, various mistakes within the preoperative workup were detected: lack of multidisciplinary discussion (n = 7, 77.8%); inappropriate imaging (n = 4, 44.4%); lack of specific blood markers (n = 7, 77.8%). The morbidity and mortality rates for mismatches were 46.7% and 0. Conclusion: All avoidable surgeries were the result of an incomplete pre-operative workup. The adequate identification of the underlying pitfalls could lead to minimize and, potentially, overcome this phenomenon with a concrete optimization of the surgical-care process.

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Inflammatory and tumor-like lesions of the pancreas

Cited by 9 publications

References 53 publications

Statin Induced Changes in Rat Pancreatic Tissue: A Histological and Biochemical Perspective

Statin Induced Changes in Rat Pancreatic Tissue: A Histological and Biochemical Perspective

Surgery for chronic pancreatitis: the comparison of two high-volume centers reveals lack of a uniform operative management

The Rate of Avoidable Pancreatic Resections at a High-Volume Center: An Internal Quality Control and Critical Review

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